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HISTORICAL  ACCOUNT 


Siamese  'Twin  Brothers , 


ACTUAL  OBSERVATIONS. 


“ UNITED  WE  STAND. 

Gopij-right  secured. 

PRICE  m CENTS. 

FOR  SALE  ONLY  AT  THE  EXHIBITION  ROOM. 


Second  Edition — 2®Q0  Each. 


NEW- YORK : 

Elliott  <Sf  Palmer,  Printers,  20  William-street. 


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-Published  as  the  Pci  directs.  Pan  _-v  Zd.  dd-367 . 


AN 


HISTORICAL  ACCOUNT 

OF  THE 


SIAMESE  TWIN  BROTHERS, 

FROM 


ACTUAL  OBSERVATIONS. 


“united  we  stand.” 


FOR  SALE  ONLY  AT  THE  EXHIBITION  ROOM. 

PRICE  121  CENTS. 

SECOND  EDITION— 2000  EACH. 


NEW-YORK : 

PRINTED  BY  ELLIOTT  AND  PALMER,  20  WILLIAM-STREET. 

1831. 


Entered  according  to  act  of  Congress,  in  the  year  1831,  by  James  W. 
Hale,  in  the  Clerk’s  office  of  the  Southern  District  of  New-York. 


Egyptian  Hall,  Piccadilly,  Nov.  24th,  1829. 


CHANG  <Sf  ENG. — Two  youths  horn  in  the  kingdom  of 
Siam,  whose  bodies  are,  by  a wonderful  caprice  of  nature,  united  to- 
gether as  one,  arrived  in  London  on  Tlmrsday,  Nov.  19 tli,  and  on 
Tuesday  24  th,  were  submitted  to  the  examination  of  the  most  eminent 
professors  of  Surgery  and  Medicine  of  the  Metropolis,  as  well  as 
some  other  gentlemen  of  scientific  and  literary  pursuits  in  order 
that  through  their  report,  {if  favourable')  the  public  may  be  assu- 
red that  the  projected  exhibition  of  these  remarkable  and  interesting 
youths  is  in  no  respect  deceptive;  and  further  that  there  is  nothing 
whatever,  offensive  to  delicacy  in  the  said  exhibition. 

These  Youths  have  passed  their  eighteenth  year,  are  in  pos- 
session c f full  health  and  extraordinary  bodily  strength  ; display 
all  the  faculties  of  the  mind  in  their  fullest  extent ; and  seem  in  fact 
in  every  respect  to  enjoy  a state  of  perfect  happiness  and  content- 
ment. 


***  The  Youths  having  been  thus  introduced  to  the  British  Public,  -were 
visited  on  that  day  (among  many  others.)  by  the  following distingui-died  per- 
sons, who  testified  their  entire  approbation  of  the  exhibition,  and  obligingly 
favoured  the  Proprietors  with  the  sanction  of  their  names. 

(Signed  by) 

HONs.  LEIGH  THOMAS,  President  ofthe  Royal  College  of  Surgeons. 


Astley  Cooper 
Thomas  Copeland 
R.  C.  Headinuton 
W.  B.  Lynn 
B.  C.  Brodie 
B.  Travers 
Charles  Locock 
Francis  Hawkins 
James  A.  Wilson 
E.  C.  Thomas 
W.  Reid  Clanney 


J.  Frost 

William  Blizard 
Joseph  H.  Green 
George  Langstaff 
James  Luke 
Henry  Halford 
J.  M.  Latham 
John  Webster 
Wm.  Babingxon 
J.  A.  Paris 
George  Blrkbeck 


Anth.  Carlisle 
J.  Macbraire 
J.  D.  Broughton 
J.  Harrison  C uktis 
William  Clift 
John  Ashburner 
William  Manning 
Edward  Stanley 
E.  H.  Phillips 
Henry  Hunt 
John  Scott,  &c. 


Having  seen  and  examined  the  two  Siamese  Youths,  Chang  ar.d 
Eng,  I have  great  pleasure  in  affirming  they  constitute  a most  ex- 
traordinary Lusus  Natures,  the  first  instance  I have  ever  seen  of  a 
living  double  child ; they  being  totally  devoid  cf  deception,  afford 
a very  interesting  spectacle,  and  they  are  highly  deserving  of  pub- 
lic patronage.  (Signed)  JOSHUA  BROOKS. 

The  above  are  from  a large  number  of  testimonials,  which  are 
open  to  the  inspection  of  the  visiters  to  the  Exhibition  in  a book 
kept  there  for  the  purpose. 


■ 


Digitized  by  the  Internet  Archive 
in  2016 


https://archive.org/details/historicalaccoun01hale_0 


ACCOUNT 


OF  THE  ^ 

SIAMESE  TIIT.V  BROTHERS* 


The  kingdom  of  Siam,  from  whence  these  interesting 
youths  were  brought,  is  situated  between  the  Chinese  and 
Burmese  empires,  and  is  tributary  to  the  former.  Bankok, 
the  capital  city  of  the  empire,  is  in  latitude  13°  N.  and 
longitude  101°  E.,  on  the  river  Minam,  about  40  miles 
from  its  mouth.  Many  of  the  houses,  which  are  of  bamboo, 
are  built  upon  rafts,  and  moored  in  the  river  in  such  situa- 
tions as  suit  the  convenience  of  the  occupiers.  There  are 
houses,  belonging  to  the  higher  classes  of  people,  on  shore 
built  of  brick,  and  painted  white;  that  of  the  King  is  en- 
closed within  walls  about  two  miles  in  circumference;  his 
household  consists  of  about  three  thousand  individuals,  of 
whom  seven  hundred  are  his  wives.  The  person  of  the 
King  is  considered  so  sacred,  that  when  he  leaves  the  pre- 
cincts of  the  palace,  (about  twice  a year,)  the  streets  are 
cleared  of  people,  the  doors  and  windows  of  all  buildings 
closed,  and  any  person  found  guilty  of  looking  at  his  most 
excellent  Majesty,  is  punished  with  immediate  death. 

The  government  of  Siam  is  probably  one  of  the  most 
despotic  and  cruel  in  the  world.  As  an  instance  of  the  ty- 
ranny of  the  King,  it  may  be  mentioned,  that  during  the 
residence  of  Capt.  Coffin  in  Bankok,  in  1829,  he  was  or- 
dered by  his  Majesty  to  witness  the  punishment  preparing 
for  the  prince  of  Laos,  who  had  revolted  from  his  allegiance, 
and  was  subsequently  taken  prisoner.  When  Capt.  Coffin 


G 


saw  him,  he  and  thirteen  of  his  family  were  confined  in  an 
iron  cage,  loaded  with  heavy  chains.  From  thence  he  was  to 
be  taken  to  the  place  of  execution,  and  there  hung  by  a hook 
to  be  inserted  under  his  chin  ; he  was  afterwards  to  be  seat- 
ed upon  sharp  pikes  five  inches  long  ; then  to  be  placed  in 
boiling  oil,  and  finally  pounded  to  pumice  in  an  immense 
mortar.  All  these  cruelties  would  doubtless  have  been  con- 
summated, had  not  the  Prince  escaped  their  horrid  infliction, 
by  poisoning  himself  the  day  before  the  sentence  was  to 
have  been  carried  into  execution. 

Eng  and  Chang,*  the  young  men  now  brought  before 
the  public,  are  natives  of  a small  village  on  the  sea-coast 
of  Siam,  called  Maklong,  about  60  miles  from  the  capital. 
They  were  born  in  May,  1811,  of  Chinese  parents,  and  are 
united  to  each  other  by  a ligature,  or  band,  about  three  and 
an  half  inches  in  length  and  eight  in  circumference  form- 
ed at  the  extremity  of  the  breast  bone  of  each,  and  ex- 
tending downwards  to  the  abdomen.  The  upper  part  of 
the  band  is  a strong  cartilaginous  substance;  the  lower 
part  is  soft  and  fleshy,  and  contains  a tube  or  cavity,  pre- 
sumed to  be  about  an  inch  and  an  half  in  circumference. 
What  the  contents  of  this  cavity  may  be,  cannot  be  deter- 
mined during  their  lives;  1 have,  however,  inserted  at  the 
end  of  the  book  the  opinions  of  scientific  men  upon  the  sub- 
ject, to  which  the  reader  is  referred.  On  the  lower  edge  of 
the  band,  exactly  in  its  centre,  is  situated  the  umbilicus  or 
navel;  (there  being  but  ONE  in  common  between  them  ;)  a 
pressure  upon  the  lower  part  of  the  band  when  they  cough, 
laugh,  or  sneeze,  would  cause  considerable  pain,  which 
would  be  equally  felt  by  each.  If  the  connecting  link  be 
touched  in  the  centre,  both  are  equally  sensible  to  it;  but 
if  half  an  inch  from  the  centre,  it  is  only  felt  by  one. 
There  is  nevertheless  a considerable  degree  of  nervous 

* It  may  be  observed  that  Eng  is  always  on  the  right,  Chang  consequently 
c n the  left.  Their  names  are  pronounced  as  if  spelt  In  and  Chun. 


7 


sympathy  between  the  iwo  bodies,  but  it  is  entirely  over- 
powered by  the  operation  of  the  mind.  This  was  strongly 
proved  at  one  time  by  Dr.  Roget,  secretary  to  the  Royal 
Society,  by  means  of  a galvanic  experiment.  I am  clearly 
of  opinion  that  there  is  a degree  of  muscular  power  in  the 
band,  and  that  strength  is  sometimes  communicated  from 
one  to  the  other.  The  flexibility  of  the  cartilage  is  so 
great,  that  they  can  readily  turn  those  shoulders  towards 
each  other,  which  are  outward  when  walking  ; indeed  there 
probably  would  have  been  no  difficulty  in  their  walking 
either  way,  had  they  learned  to  do  so  when  young.  Their 
mother  observed  that  she  suffered  no  greater  inconve- 
nience at  their  birth,  than  at  those  of  former  children,  as 
they  were  very  small,  and  the  head  of  one  was  presented 
between  the  legs  of  the  other.  She  has  had  a number  of 
other  children  without  any  peculiarity',  all  of  whom  ex- 
cepting Chang  and  Eng,  and  a brother  and  sister,  are  dead. 
Their  father  died  when  they  were  eight  years  of  age; 
about  the  same  time  they  w'ere  severely  affected  with 
the  small  pox,  and  shortly  afterwards,  the  measles ; by 
both  these  disorders  they  were  equally  ill,  recovered  at 
the  same  moment,  and  by  the  same  remedies.  Since  that 
time  they'  have  never  suffered  by  any  illness,  excepting 
occasionally  a slight  cough.  They  have  been  several 
months  at  sea,  but  never  were  ill  in  consequence  of  it,  so 
as  to  cause  nausea  ; on  the  contrary,  they  were  always 
remarkably  well  on  shipboard,  would  frequently  go  aloft, 
and  many  times  have  expressed  a wish  that  they  might  at 
some  future  day  command  a ship  of  their  own. 

Their  parents  were  of  the  poorer  class,  and  until  the 
youths  left  their  home,  they  were  engaged  in  fishing, 
manufacturing  cocoanut  oil,  keeping  poultry,  &lc.  for  the 
support  of  their  family.'  A visitor  once  asked  them  what 
was  their  occupation  in  their  own  country  ; when  they  fa- 


8 


cetiously  answered  that  they  were  merchants,  having  been 
engaged  in  the  duck  and  egg  trade. 

They  left  Siam  on  the  1st  April,  1829,  under  the  pro- 
tection of  Capt.  Abel  Coffin,  on  board  the  American  ship 
Sachem,  which  was  commanded  by  him,  and  who  had 
obtained  the  consent  of  their  parent  and  of  the  govern- 
ment, to  their  leaving  the  country.  The  mother  and  chil- 
dren were  equally  pleased  with  the  voyage,  as  a sufficiency 
was  left  for  her  support,  and  all  were  aware  of  the  respect- 
ability of  those  in  whose  charge  they  were  placed.  The 
youths  never  express  any  desire  to  return  to  their  native 
country,  excepting  to  visit  their  friends,  after  which  they 
hope  to  pass  the  remainder  of  their  lives  in  Europe  or 
America. 

They  are  as  near  as  possible  of  the  same  height,  about 
five  feet  two  inches  ; are  finely  formed  in  every  respect, 
and  possess  a great  degree  of  muscular  power  for  persons 
of  their  size.  I have  known  them  to  carry  a person  up- 
wards of  an  hundred  feet,  whose  weight  was  280  pounds; 
and  to  throw  others  without  any  difficulty,  whose  weight 
much  exceeded  theirs,  which  was  on  the  1st  Jan.  1831, 
210  pounds;  having  gained  40  pounds  within  a year. 
They  are  remarkably  agile,  can  walk  or  run  with  great 
swiftness,  and  can  swim  as  well  as  most  singlt-  persons. 
Their  activity  can  readily  be  imagined  by  those  w ho  have 
seen  them  playing  at  battledore  and  shuttlecock,  a game 
of  which  they  are  particularly  fond,  as  combining  exer- 
cise with  recreation.  They  continue  to  dress  in  their  na- 
tive costume,  and  their  hair,  which  is  about  four  feet  in 
length,  i'  braided  in  the  Chinese  style.  In  doing  this,  in 
washing,  dressing,  or  in  any  other  occupation,  they  re- 
quire no  assistance,  each  acting  for  himself  with  as  per- 
fect ease  as  would  an  individual. 

Their  intellectual  powers  are  very  acute,  and  in  this 


9 


respect  it  has  not  been  observed  that  one  possesses  the 
slightest  decree  of  superiority  over  the  other.  The  wisdom 
of  Providence  is  herein  strongly  manifested;  for  did  any 
mental  superiority  exist,  it  would  necessarily  lead  to  con- 
tentions and  struggles  for  pre-eminence,  which  happily  is 
so  far  from  being  the  case,  that  many  who  have  visited  them, 
have  left  them  under  the  impression  that  they  were  actuated 
by  only  one  mind,  so  simultaneous  were  they  in  ali  their 
movements.  They  play  at  chess  and  draughts  remarkably 
well,  but  never  in  opposition  to  each  other:  having  been 
asked  to  do  it,  they  replied  that  no  more  pleasure  would  be 
derived  from  it,  than  by  playing  with  the  right  hand  against 
the  left. 

They  are  so  conversant  with  the  English  language,  that 
they  can  understand  all  that  is  said  to  them,  and  converse 
with  tolerable  fluency  : they  are  also  very  desirous  to  make 
themselves  generally  acquainted  with  the  manners  and  cus- 
toms of  our  country. 

A volume  might  be  filled  by  enumerating  their  shrewd- 
ness and  keenness  of  remark ; and  to  mention  one  or  two 
instances  here  may  not  be  deemed  improper.  A visitor  once 
came  into  the  room,  who  had  but  one  ey-* ; upon  which  they 
observed  to  the'door-keeper  that  the  gentleman  should  have 
paid  only  half  price  for  admission,  as  he  had  only  half  the 
chance  to  see  which  others  had.  On  seeing  a cripple  who 
had  lost  both  hands  and  feet,  they  made  him  a present, 
remarking  that  as  they  had  four  hands  and  he  none,  it  was 
not  only  a pleasure,  but  their  duty  to  assist  him. 

The  ex-king  of  France,  Charles  X.  once  visited  them 
in  Liverpool,  and  on  leaving  them,  made  them  a present 
of  a piece  of  gold  ; after  he  was  gone,  they  observed  that 
they  supposed  the  reason  why  he  gave  them  gold,  was  be- 
cause he  had  no  crown.  Indeed,  there  are  few  who  visit 
them,  who  escape  their  notice,  and  they  generally  amuse 


10 


themselves  and  friends  an  hour  or  two  in  the  evening,  by 
relating  some  of  the  strange  observations  they  have  heard 
during  the  da}',  and  in  remarks  upon  those  they  have  seen 
at  the  exhibition  room. 

Their  feelings  are  warm  and  affectionate,  and  their  con- 
duct amiable  and  well-regulated.  They  are  very  suscepti- 
ble, and  an  act  of  kindness  or  affectionate  treatment  of  any 
description  is  never  forgotten,  while  an  injury  or  insult 
offered  to  one  is  equally  resented  by  the  other.  They 
never  enter  into  conversation  or  discussion  with  each  other, 
because,  possessing  as  before  observed  the  same  quantum 
of  intellect,  and  having  been  placed  constantly  in  the  same 
circumstances,  precisely  the  same  effects  have  been  produced 
upon  the  mind  of  each  ; therefore  they  have  not  that  to  com- 
municatewhich  two  other  beings  would  have  underthe  com- 
mon circumstances  of  distinct  observation.  It  is  occasion- 
ally observed  that  a simple  remark  may  be  made  by  one  to 
the  other,  but  I have  never  known  them  to  enter  into  con- 
versation with  each  other.  The  attempt  has  been  frequent- 
ly made  to  engage  them  in  separate  conversations  with 
different  individuals,  but  without  success,  as  they  are  in- 
variably inclined  to  direct  their  attentions  to  the  same  thing 
at  the  same  time. 

In  their  movements  the  most  perfect  equanimity  is  ob- 
served, the  one  always  concurring  with  the  other  so  exactly, 
that  they  appear  as  if  actuated  by  one  common  mind,  and 
it  is  next  to  impossible,  by  the  strictest  scrutiny  to  discover 
with  which  the  impulse  originates,  whenever  they  arise  of 
their  own  accord.  In  their  necessary  employments  of  life, 
or  in  their  amusements,  they  have  never  been  known  to 
pass  an  angry  word  with  each  other ; and  whenever  either 
wishes  to  pursue  any  particular  course,  he  immediately 
follows  the  bent  of  his  inclinations,  without  the  least  inti- 
mation by  word  or  motion  to  the  other,  who,  nevertheless, 


11 


readily  coincides,  and  without  the  slightest  hesitation, 
moves  wherever  the  will  of  the  former  may  direct.  As 
the  one  always  assents  to  the  movements  of  the  other,  and 
as  no  words  pass  between  them,  it  is  curious  to  imagine  how 
such  assent  is  conveyed. 

Their  appetites  are  remarkably  good,  and  they  are  now 
quite  accustomed  to,  and  pleased  with,  the  general  living 
of  this  country.  Their  usual  beverage  is  tea,  coffee,  or 
water;  wine  or  spirits  they  seldom  taste.  Their  likings 
or  distastes  for  particular  food  are  the  same  precisely  ; 
whatever  pleases  one,  gratifies  also  the  other;  and  any 
thing  unpleasant  to  one,  has  the  same  effect  upon  the  mind 
of  his  brother.  This  remark  applies  not  only  to  food,  but 
also  to  persons  and  things  with  w hich  they  come  in  con- 
tact. They  invariably  feel  hunger  and  thirst  at  the  same 
time,  and  the  quantity  of  food  taken  by  them  is  as  nearly 
alike  as  possible. 

Both  feel  the  desire  to  sleep  simultaneously,  and  they 
always  awake  at  the  same  moment.  I have  never  yet 
known  one  to  be  sleeping  and  the  other  awake  at  the  same 
time;  indeed,  when  asleep,  so  great  is  the  nervous  sympa- 
thy which  exists  between  them,  that  a touch  upon  the  body 
of  either  will  awaken  both.  While  in  bed,  they  are  not 
confined  to  any  particular  position,  but  rest  on  either  side, 
as  may  best  suit  their  convenience,  generally,  however, 
with  their  faces  towards  each  other.  They  usually  sleep 
nine  or  ten  hours  each  night,  and  quite  soundly  ; when 
they  do  feel  restless,  and  desire  to  vary  their  position,  the 
one  must  roll  entirely  over  the  other,  and  they  have  fre- 
quently been  observed  to  do  this  without  either  awaking  or 
being  apparently  disturbed  by  the  change. 

Upon  the  possibility  or  otherwise  of  separating  them  by 
surgical  means,  some  difference  appears  in  the  opinions  of 
scientific  men ; ninety-nine  in  an  hundred  believe  it  alto- 


12 


gether  impossible,  and  all,  that  it  would  be  an  experiment 
of  such  risk,  as  not  to  be  warranted,  unless  in  the  event  of 
the  death  of  one;  and  that  is  considered  as  almost  an  im- 
possibility, in  consequence  of  the  strong  degree  of  circu- 
lation which  is  between  them.  It  is,  however,  to  them  a 
very  unpleasant  subject,  and  they  feel  quite  averse  to  have 
it  spoken  of.  They  have  often  remarked,  that  they  never 
saw  any  single  person  as  happv  as  they  are,  therefore  they 
have  no  reason  to  wish  for  a change. 

The  humidity  of  a northern  climate  did  not  at  first  agree 
with  them,  the  weather,  on  their  arrival  in  England,  being 
unceasingly  damp  and  foggy  ; both,  inconsequence,  were 
severely  affected  by  colds  and  coughs,  in  equal  degrees, 
from  which  they  recovered  simultaneously-  During  the 
dark  and  foggy  days,  they  would  sometimes  take  a deaden- 
ed coal  from  the  grate,  and,  holding  it  up,  call  it  the  Lon- 
don sun  ; and  the  day  after  their  arrival  there,  it  being 
necessary  to  have  lighted  candles  in  the  drawing  room  at 
noon,  in  consequence  of  the  fog  and  smoke,  they  went  to 
bed,  insisting  that  it  was  not  possible  it  could  be  day-time. 
Snow  they  had  never  seen  till  they  went  to  England,  and 
bn  first  viewing  it,  they  were  much  astonished,  inquiring 
whether  it  was  sugar  or  salt. 

The  youths  arrived  in  the  United  States  from  their  na- 
tive country,  in  August,  1829  ; remained  in  America  eight 
weeks,  and  embarked  for  London,  where  they  arrived  on 
the  19th  November  following.  They  remained  in  Great 
Britain  until  January,  1S31,  having  travelled  upwards  of 
2500  miles  in  the  kingdom,  and  received  the  visits  of  about 
300,000  individuals  in  London,  Edinburgh.  Dublin,  Li- 
verpool, Manchester,  Bath,  Leeds,  York,  Sheffield,  Bristol, 
Birmingham,  and  most  of  the  principal  cities  and  towns 
in  the  kingdom.  They  were  honoured  by  visits  from  her 
Majesty,  Queen  Adelaide,  and  others  of  the  Royal  family, 


13 


the  foreign  ambassadors,  nobility,  and  by  most  of  the  phi- 
losophers and  scientific  men  of  the  age. 

Having  thus,  in  order  to  gratify  public  curiosity,  hastily 
put  together  a few  prominent  facts  regarding  this  extraor- 
dinary variety  in  the  works  of  Almighty  power,  it  need 
scarcely  be  observed,  that  the  most  fastidious  female  will 
find  nothing  in  the  exhibition  to  wound  her  delicate  feelings. 
Ladies  of  the  first  rank,  both  in  Europe  and  America,  have 
visited  them  daily  in  great  numbers;  and  of  all  who  have 
honoured  them  with  their  company,  none  have  appeared 
more  gratified  than  the  gentler  sex. 

Being  constantly  with  them,  ladies  and  gentlemen  may 
feel  assured  that  I shall  at  all  times  be  happy  to  give  any 
further  information  in  my  power,  and  that  all  questions  re- 
specting- them  will- be  most  cheerfully  answered. 

JAS.  W.  HALE. 

In  order  to  gratify  the  numerous  professional  and  sci- 
entific gentlemen  who  continually  visit  the  exhibition 
room,  the  following  remarks  are  subjoined.  The  first 
paper  was  written  by  George  B.  Bolton,  Esq.,  member  of 
the  Royal  College  of  Surgeons,  &c.,  London,  and  who 
was  their  constant  medical  attendant  while  there.  The 
latter  isfrom  a paper  by  Drs.  Mitchil!  and  Anderson,  writ- 
ten at  the  time  of  their  visit  to  America,  in  1829. 

Extracts from  a paper  read  before  the  Royal  Society,  London, 
April  1st,  1830,  by  G.  B.  Bolton,  Esq. 

********  “The  band  of  union  is  formed  in 
the  following  manner : At  the  lowest  part  of  the  sternum  o!  each 
boy,  the  ensiform  cartilage  is  bent  upwards  and  forwards,  meet- 
ing the  other  in  the  middle  of  the.  upper  part  of  the  band,  where 
moveable- joints  exist,  which  admit  of  vertical  as  well  as  lateral 
motion,  each  junction  appearing  to  be  connected  by  ligamentous 


14 


structures.  It  is  difficult  to  define  precisely  where  the  respective 
cartilages  from  each  body  meet,  and  whether  a slip  from  one  of 
the  cartilages  of  the  false  ribs  enters  into  the  structure  of  these 
parts;  but  it  is  certain  that  the  ensiform  cartilages  have  assumed 
an  extended  and  altered  figure.  This_cartilagenous  portion  oc- 
cupies the  upper  region  ol  the  band.  The  outline  of  the  baud 
is  convex  above  and  arched  below.  Under  the  cartilage,  while 
they  stand  in  their  ordinary  posture,  are  large  hernial  sacs, 
opening  into  each  abdomen,  and  into  which,  on  coughing,  con- 
genital herniae  are  lorced,  probably  in  each  boy,  formed  by  a 
portion  of  the  transverse  arch  of  the  colon  ; generally,  however, 
and  under  ordinary  circumstances, these  herniae  are  not  apparent. 
Whether  there  is  a communication  between  the  two  abdominal 
cavities,  or  a distinct  peritoneal  sac  belonging  to  each  hernia,  is 
by  no  means  obvious.  **■**■*•*■*#*** 
“When  these  herniae  protrude,  their  respective  contents  are 
pushed  forwards  as  far  as  the  middle  of  the  band.  The  entire 
band  is  covered  with  common  integument ; and  when  the  youths 
face  each  other,  its  length  at  the  upper  edge  is  two,  and  at  the 
lower,  not  quite  four  inches.  From  above,  downwards,  it  is 
three  inches  and  a quarter,  and  its  greatest  thickness  is  one  inch 
and  five  eighths.  In  the  centre  of  the  lower  part  of  this  band, 
which  presents  a thin  edge,  formed  only  by  skin  and  cellular 
substance,  there  is  the  cicatrix  of  a single  navel,  showing  where 
the  umbilical  cord  or  cords  had  entered,  and  which.  I have  no 
doubt,  contained  two  sets  of  vessels.  Small  blood-vessels  and 
nerves  must  of  course  traverse  the  substance  of  the  band.  * * * 
I have  had  an  opportunity  of  examining  a preparation  of  united 
female  twins,  now  in  the  museum  of  the  Royal  College  of  Sur- 
geons in  London.  The  union  extends  from  the  lower  part  of 
the  sternum  of  each  twin  to  the  navel ; and  there  is  one  umbili- 
cal cord  common  to  both.  On  dissection,  the  following  appear- 
ances were  observed.  The  umbilical  vein,  in  its  course  towards 
the  twins,  is  divided  into  two  r. early  equal  sized  branches,  the  di- 
vision taking  place  at  about  one  inch  and  three  quarters  from  the 
umbilicus ; one  branch  passing  upwards  in  front  to  the  porta  of 
the  anterior  liver,  and  the  other  behind  to  its  proper  liver.  The 


15- 


number  of  arteries  are  four,  two  from  each  foetus,  and  are  includ- 
ed in  the  same  theca  with  the  umbilical  vein  as  far  as  the  body, 
retaining  the  appearance  of  an  ordinary  funis.” 

Extracts  from  a paper  by  Drs.  Sami.  L.  Mitchill  and  \Vm.  An- 
derson, of  New-  York. 

The  ensiform  cartilage  at  the  end  of  each 
sternum  is  united  to  its  fellow,  and  has  been  in  part  ossified, 
forming  a hard  elastic  upper  edge  to  the  band  which  connects 
these  hoys.  This  is  convex  upward  and  concave  below,  becom- 
ing the  upper  boundary  of  a canal,  which  is  in  the  band,  that 
communicates  with  the  abdominal  cavities  of  both  the  youths, 
from  which  fact,  the  canal  is  necessarily  lined  by  a continuation 
of  the  natural  peritoneal  membrane  of  the  cavities,  and  the  whole 
of  this  is  covered  by  common  integuments.  At  about  midway 
in  the  under  edge  of  the  band,  is  exhibited  the  cicatrix  of  an  um- 
bilicus, shewing  wherein  the  single  cord,  but  no  doubt  containing 
two  sets  of  vessels,  entered,  for  the  nourishment  of  these  two 
children  before  birth. 

“ Into  the  canal  of  this  almost  cylindrical  band,  there  is  a pro- 
trusion of  the  viscus  from  the  abdomen  of  its  respective  boy, 
upon  every  effort  of  coughing  or  other  exercise  ; and  these  pro- 
trusions, from  their  particular  hardness  and  size,  more  at  some 
times  than  others,  we  might  suppose  to  be  made  up  of  any  of  the 
abdominal  viscera, as  intestine,  liver,  stomach,  or  spleen,  as  each 
should  happen  in  the  various  positions  of  their  bodies,  to  be  pre- 
sented to  the  openings,  since  we  believe  that  parts  of  every  abdo- 
minal or  pelvic  viscus,  excepting  the  kidneys,  have  been  found 
from  time  to  time  to  enter  into  the  composition  of  hernial  tu- 
mours. 

“A  question  has  arisen,  which  has  been  discussed  with  some 
warmth,  whether  they  could  be  separated  with  safety.  We  think 
they  could  not ; and  would  barely  refer  to  the  experience  of  Scar- 
pa and  Sir  Astley  Cooper,  with  whom  might  be  included  a host  of 
others,  quite  familiar  to  the  well-read  surgeon,  for  a decision  upon 
the  ill  success  of  the  operation  for  exomphalos.  Dionis,  you 


1G 


know,  says,  in  relation  to  the  operation  for  umbilical  hernia,  ‘that 
those  who  have  the  misfortune  to  be  afflicted  with  an  exomphalos, 
should  rather  dispense  with  r shirt  than  a well  adapted  truss 
and  Acister  says  much  about  the  same  thing.  Sir  Astley  Cooper 
has  said  in  hearing  of  one  of  the  writers  in  his  public  lectures 
more  than  twenty  years  ago,  ‘ Gentlemen,  I have  operated  • for 
umbilical  hernia  once,  and  shall  never  do  it  again hinting  at  the 
general  fatal  issue  of  the  operation  then  in  practice,  since  heh  d 
cut  into  the  peritoneal  cavity  at  the  umbilicus.  Professor  Scar- 
pa, the  acknowledged  distinguished  anatomist  and  surgeon, 
speaks  of  the  great  fatality  of  the  usual  operation  for  exompha- 
los  ; and  recommends  the  one,  when  necessary,  which  has  oflate 
been  in  practice  by  Sir  Astley  Cooper,  which  consists  in  dividing 
the  stricture  and  performing  the  whole  operation  without  cutting 
into  any  part  of  the  hernial  sac,  or  peritoneal  membrane,  under 
which  circumstances,  it  has  with  Sir  Astley  Cooper  been  twice 
successful.  Now  if  such  an  operation  could  be  practicable,  for 
the  liberation  of  these  boys,  then  it  might  be  deemed  advisable, 
other  permissions  co-operating  ; but  since  any  ct  tting  accom- 
plishing their  separation,  (if  our  description  of  their  connexion  be 
correct,)  would  expose  the  peritoneal  cavity,  then,  in  that  situa- 
tion, it  would  be  attended  with  the  most  dangerous  consequen- 
ces.” 


I 

Hale 

1831 


